NPIMap

Individual provider Active NPI

Christopher Phillip Samuels, M.D.

  • Family Medicine Physician
  • White Salmon, WA
National Provider Identifier
1780660175
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00047504 Issued in WA
Practice address
212 Skyline Dr
White Salmon, WA 98672
Phone
(509) 493-2133
Fax
(509) 493-9544
NPI assigned
Dec 19, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 22673 NE
Family Medicine Physician 207Q00000X MD00047504 WA Primary
Family Medicine Physician 207Q00000X MD27417 OR

Addresses

Primary practice location

212 Skyline Dr
White Salmon, WA 98672

Mailing address

PO Box 1519
White Salmon, WA 98672-1519
Phone (509) 493-2133

Other identifiers 3

IdentifierTypeStateIssuer
8478117MedicaidWA
P00462561OtherWAPTAN
274532MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070607000686 WA Practitioner - Family Practice 6103924568 Reassigns benefits to 2 organizations
I20231127001702 OR Practitioner - Family Practice 6103924568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
One Community HealthGroup PAC ID 6305759283, shared by 7 NPIs, 51 clinicians

Practice addresses (Care Compare)

211 NE Skyline Dr
White Salmon, WA 98672-1948
Phone (509) 493-1101

65371 Hwy 14
White Salmon, WA 98672-8690
Phone (509) 493-2133

849 Pacific Ave
Hood River, OR 97031-1956
Phone (541) 386-6380

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22673NEMDFamily Medicine Physician
MD27417ORMDFamily Medicine Physician
MD00047504WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
One Community Health CurrentSince Nov 1, 2023 Accepting new patients
One Community Health CurrentSince May 14, 2024 Accepting new patients
Public Hospital District No 2, Klickitat County, Washington CurrentSince Sep 1, 2007 Accepting new patients
One Community Health Current Accepting new patients
Public Hospital District No 2, Klickitat County Washington CurrentSince Sep 1, 2007 Accepting new patients
One Community Health CurrentSince Nov 1, 2023 Accepting new patients

Locations

849 Pacific Ave
Hood River, OR 97031
Phone (541) 386-6380

875 SW Rock Creek Dr
Stevenson, WA 98648
Phone (509) 427-4212

212 NE Skyline Dr
White Salmon, WA 98672
Phone (509) 493-2133

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/ac6e817f-dc27-43e8-b886-6559f137e853/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1780660175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1519",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "986721519",
            "telephone_number": "509-493-2133",
            "fax_number": "509-493-9544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 SKYLINE DR",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "98672",
            "telephone_number": "509-493-2133",
            "fax_number": "509-493-9544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "CHRISTOPHER",
        "middle_name": "PHILLIP",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "22673",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00047504",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD27417",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8478117",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "P00462561",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274532",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Salmon, WA

Sources for this page

Verify at the official NPI Registry.